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Jonkman AH, Warnaar RSP, Baccinelli W, Carbon NM, D'Cruz RF, Doorduin J, van Doorn JLM, Elshof J, Estrada-Petrocelli L, Graßhoff J, Heunks LMA, Koopman AA, Langer D, Moore CM, Nunez Silveira JM, Petersen E, Poddighe D, Ramsay M, Rodrigues A, Roesthuis LH, Rossel A, Torres A, Duiverman ML, Oppersma E. Analysis and applications of respiratory surface EMG: report of a round table meeting. Crit Care 2024; 28:2. [PMID: 38166968 PMCID: PMC10759550 DOI: 10.1186/s13054-023-04779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
Surface electromyography (sEMG) can be used to measure the electrical activity of the respiratory muscles. The possible applications of sEMG span from patients suffering from acute respiratory failure to patients receiving chronic home mechanical ventilation, to evaluate muscle function, titrate ventilatory support and guide treatment. However, sEMG is mainly used as a monitoring tool for research and its use in clinical practice is still limited-in part due to a lack of standardization and transparent reporting. During this round table meeting, recommendations on data acquisition, processing, interpretation, and potential clinical applications of respiratory sEMG were discussed. This paper informs the clinical researcher interested in respiratory muscle monitoring about the current state of the art on sEMG, knowledge gaps and potential future applications for patients with respiratory failure.
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Affiliation(s)
- A H Jonkman
- Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R S P Warnaar
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - W Baccinelli
- Netherlands eScience Center, Amsterdam, The Netherlands
| | - N M Carbon
- Department of Anesthesiology, Friedrich Alexander-Universität Erlangen-Nürnberg, Uniklinikum Erlangen, Erlangen, Germany
| | - R F D'Cruz
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Doorduin
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J L M van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Elshof
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - L Estrada-Petrocelli
- Facultad de Ingeniería and Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) - Sistema Nacional de Investigación (SNI), Universidad Latina de Panamá (ULATINA), Panama, Panama
| | - J Graßhoff
- Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
| | - L M A Heunks
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A A Koopman
- Division of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - D Langer
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - C M Moore
- Netherlands eScience Center, Amsterdam, The Netherlands
| | - J M Nunez Silveira
- Hospital Italiano de Buenos Aires, Unidad de Terapia Intensiva, Ciudad de Buenos Aires, Argentina
| | - E Petersen
- Technical University of Denmark (DTU), DTU Compute, 2800, Kgs. Lyngby, Denmark
| | - D Poddighe
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - M Ramsay
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Rodrigues
- Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - L H Roesthuis
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Rossel
- Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - A Torres
- Institut de Bioenginyeria de Catalunya (IBEC), Barcelona Institute of Science and Technology (BIST) and Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Politècnica de Catalunya BarcelonaTech (UPC), Barcelona, Spain
| | - M L Duiverman
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - E Oppersma
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands.
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Singh S, Brandenburg JT, Choudhury A, Gómez-Olivé FX, Ramsay M. Systematic Review of Genomic Associations with Blood Pressure and Hypertension in Populations with African-Ancestry. Front Genet 2021; 12:699445. [PMID: 34745203 PMCID: PMC8564494 DOI: 10.3389/fgene.2021.699445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/10/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Despite hypertension being highly prevalent in individuals with African-ancestry, they are under-represented in large genome-wide association studies. Inclusion of African participants is essential to better understand genetic associations with blood pressure-related traits in Africans. This systematic review critically evaluates existing studies with African-ancestry participants and identifies knowledge gaps. Methods: We followed the PRISMA protocol, HuGE Review handbook to identify literature on original research, in English, on genetic association studies for blood pressure-related traits (systolic and diastolic blood pressure, pulse and mean-arterial pressure, and hypertension) in populations with African-ancestry (January 2007 to April 2020). A narrative synthesis of the evidence was conducted. Results: Twelve studies with African-ancestry participants met the eligibility criteria, within which 10 studies met the additional genetic association data criteria (i.e., reporting only on African-ancestry participants). Across the five blood pressure-related traits, 26 genome-wide significantly associated SNPs were identified, with six SNPs linked to more than one trait, illustrating pleiotropic effects. Among the SNP associations, 12 had not previously been described in non-African studies. Discussion: The limited number of relevant studies highlights the dearth of genomic association studies on participants with African-ancestry, especially those located within Africa. Variations in study methodology, participant inclusion, adjustment for covariates (e.g., antihypertensive medication) and relatively small sample sizes make comparisons challenging, and have resulted in fewer significant associations, compared to large European studies. Regional variation in the prevalence and associated risk factors of hypertension across Africa makes a compelling argument to develop African cohorts to facilitate large genomic studies, using African-centric arrays. Data harmonisation and comparable study designs, such as described in the H3Africa CHAIR initiative, provide a good example toward achieving this goal. Other relevant information: SS and J-TB were funded by the South African National Research Foundation. MR is a South African Research Chair in Genomics and Bioinformatics of African populations hosted by the University of the Witwatersrand, funded by the Department of Science and Innovation, and administered by the NRF. This review was registered at PROSPERO (registration number: CRD42020179221) and OSF (registration DOI: 10.17605/OSF.IO/QT2HA).
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Affiliation(s)
- S Singh
- Sydney Brenner Institute for Molecular Bioscience (SBIMB), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, School of Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - J-T Brandenburg
- Sydney Brenner Institute for Molecular Bioscience (SBIMB), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A Choudhury
- Sydney Brenner Institute for Molecular Bioscience (SBIMB), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - F X Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - M Ramsay
- Sydney Brenner Institute for Molecular Bioscience (SBIMB), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, School of Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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3
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Verberk JDM, van Dongen JAP, van de Kassteele J, Andrews NJ, van Gaalen RD, Hahné SJM, Vennema H, Ramsay M, Braeckman T, Ladhani S, Thomas SL, Walker JL, de Melker HE, Fischer TK, Koch J, Bruijning-Verhagen P. Impact analysis of rotavirus vaccination in various geographic regions in Western Europe. Vaccine 2021; 39:6671-6681. [PMID: 34635375 DOI: 10.1016/j.vaccine.2021.09.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/30/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Universal mass vaccination (UMV) against rotavirus has been implemented in many but not all European countries. This study investigated the impact of UMV on rotavirus incidence trends by comparing European countries with UMV: Belgium, England/Wales and Germany versus countries without UMV: Denmark and the Netherlands. METHODS For this observational retrospective cohort study, time series data (2001-2016) on rotavirus detections, meteorological factors and population demographics were collected. For each country, several meteorological and population factors were investigated as possible predictors of rotavirus incidence. The final set of predictors were incorporated in negative binomial models accounting for seasonality and serial autocorrelation, and time-varying incidence rate ratios (IRR) were calculated for each age group and country separately. The overall vaccination impact two years after vaccine implementation was estimated by pooling the results using a random effects meta-analyses. Independent t-tests were used to compare annual epidemics in the pre-vaccination and post-vaccination era to explore any changes in the timing of rotavirus epidemics. RESULTS The population size and several meteorological factors were predictors for the rotavirus epidemiology. Overall, we estimated a 42% (95%-CI 23;56%) reduction in rotavirus incidence attributable to UMV. Strongest reductions were observed for age-groups 0-, 1- and 2-years (IRR 0.47, 0.48 and 0.63, respectively). No herd effect induced by UMV in neighbouring countries was observed. In all UMV countries, the start and/or stop and corresponding peak of the rotavirus season was delayed by 4-7 weeks. CONCLUSIONS The introduction of rotavirus UMV resulted in an overall reduction of 42% in rotavirus incidence in Western European countries two years after vaccine introduction and caused a change in seasonal pattern. No herd effect induced by UMV neighbouring countries was observed for Denmark and the Netherlands.
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Affiliation(s)
- J D M Verberk
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - J A P van Dongen
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - J van de Kassteele
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - N J Andrews
- Statistics, Modelling, and Economics Department, Public Health England (PHE), London, United Kingdom
| | - R D van Gaalen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - S J M Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - H Vennema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - M Ramsay
- Statistics, Modelling, and Economics Department, Public Health England (PHE), London, United Kingdom
| | - T Braeckman
- Formerly at Service Epidemiology of Infectious Diseases, Department Public Health and Surveillance, Sciensano Institute, Brussels, Belgium
| | - S Ladhani
- Immunisation Department, Public Health England (PHE), London, United Kingdom
| | - S L Thomas
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - J L Walker
- Immunisation Department, Public Health England (PHE), London, United Kingdom; Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - H E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - T K Fischer
- Virology Surveillance and Research, Department of Virology and Special Microbiology Diagnostics Statens Serum Institut (SSI), Copenhagen, Denmark and University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - J Koch
- Immunization Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
| | - P Bruijning-Verhagen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
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4
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Paterson P, Mounier-Jack S, Saliba V, Yarwood J, White J, Ramsay M, Chantler T. Strengthening HPV vaccination delivery: findings from a qualitative service evaluation of the adolescent girls' HPV vaccination programme in England. J Public Health (Oxf) 2021; 43:189-196. [PMID: 31219155 PMCID: PMC8042364 DOI: 10.1093/pubmed/fdz061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In 2014, the number of HPV vaccine doses given to adolescent girls as part of the English school-based immunization programme was reduced from three to two. This was based on evidence that a two-dose schedule provides long-lasting protection against HPV infection. In 2015/16 a small decline in HPV vaccination coverage in adolescent girls was noted; from 86.7% for the three-dose schedule in 2013/14 to 85.1% for the two-dose schedule. This evaluation examined whether service-related factors contributed to this decline. METHODS In May-August 2017, we conducted semi-structured qualitative interviews with 39 participants responsible for commissioning or delivering immunization programmes in six local authorities in the South West, North Central Midlands and South Central Midlands, England. RESULTS Effective planning and data management were key for successful service provision of HPV vaccination, as well as close collaboration between commissioners, service providers and data system managers, a team skill mix with experienced staff, pro-active engagement with schools and service providers equipped to respond to parental concerns. CONCLUSIONS To maintain and improve the high HPV adolescent girls' vaccine coverage rates achieved in England, in the context of an expanding school-based immunization programme, it is essential to strengthen the organizational capacity of the delivery system.
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Affiliation(s)
- P Paterson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - S Mounier-Jack
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - V Saliba
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, UK
| | - J Yarwood
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, UK
| | - J White
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - M Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, UK
| | - T Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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5
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Norreys PA, Ceurvorst L, Sadler JD, Spiers BT, Aboushelbaya R, Mayr MW, Paddock R, Ratan N, Savin AF, Wang RHW, Glize K, Trines RMGM, Bingham R, Hill MP, Sircombe N, Ramsay M, Allan P, Hobbs L, James S, Skidmore J, Fyrth J, Luis J, Floyd E, Brown C, Haines BM, Olson RE, Yi SA, Zylstra AB, Flippo K, Bradley PA, Peterson RR, Kline JL, Leeper RJ. Preparations for a European R&D roadmap for an inertial fusion demo reactor. Philos Trans A Math Phys Eng Sci 2021; 379:20200005. [PMID: 33280565 PMCID: PMC7741006 DOI: 10.1098/rsta.2020.0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 06/12/2023]
Abstract
A European consortium of 15 laboratories across nine nations have worked together under the EUROFusion Enabling Research grants for the past decade with three principle objectives. These are: (a) investigating obstacles to ignition on megaJoule-class laser facilities; (b) investigating novel alternative approaches to ignition, including basic studies for fast ignition (both electron and ion-driven), auxiliary heating, shock ignition, etc.; and (c) developing technologies that will be required in the future for a fusion reactor. A brief overview of these activities, presented here, along with new calculations relates the concept of auxiliary heating of inertial fusion targets, and provides possible future directions of research and development for the updated European Roadmap that is due at the end of 2020. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 2)'.
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Affiliation(s)
- P. A. Norreys
- Department of Physics, University of Oxford, Oxford, UK
- UKRI-STFC Central Laser Facility, Didcot, UK
| | - L. Ceurvorst
- CELIA, Université de Bordeaux-CNRS-CEA, Talence, France
| | - J. D. Sadler
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - B. T. Spiers
- Department of Physics, University of Oxford, Oxford, UK
| | | | - M. W. Mayr
- Department of Physics, University of Oxford, Oxford, UK
| | - R. Paddock
- Department of Physics, University of Oxford, Oxford, UK
| | - N. Ratan
- Department of Physics, University of Oxford, Oxford, UK
| | - A. F. Savin
- Department of Physics, University of Oxford, Oxford, UK
| | - R. H. W. Wang
- Department of Physics, University of Oxford, Oxford, UK
| | - K. Glize
- UKRI-STFC Central Laser Facility, Didcot, UK
| | | | - R. Bingham
- UKRI-STFC Central Laser Facility, Didcot, UK
- University of Strathclyde, Glasgow, UK
| | - M. P. Hill
- Atomic Weapons Establishment, Aldermaston, UK
| | - N. Sircombe
- Atomic Weapons Establishment, Aldermaston, UK
| | - M. Ramsay
- Atomic Weapons Establishment, Aldermaston, UK
| | - P. Allan
- Atomic Weapons Establishment, Aldermaston, UK
| | - L. Hobbs
- Atomic Weapons Establishment, Aldermaston, UK
| | - S. James
- Atomic Weapons Establishment, Aldermaston, UK
| | - J. Skidmore
- Atomic Weapons Establishment, Aldermaston, UK
| | - J. Fyrth
- Atomic Weapons Establishment, Aldermaston, UK
| | - J. Luis
- Atomic Weapons Establishment, Aldermaston, UK
| | - E. Floyd
- Atomic Weapons Establishment, Aldermaston, UK
| | - C. Brown
- Atomic Weapons Establishment, Aldermaston, UK
| | - B. M. Haines
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - R. E. Olson
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - S. A. Yi
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - K. Flippo
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | | | - J. L. Kline
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - R. J. Leeper
- Los Alamos National Laboratory, Los Alamos, NM, USA
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Spiers BT, Hill MP, Brown C, Ceurvorst L, Ratan N, Savin AF, Allan P, Floyd E, Fyrth J, Hobbs L, James S, Luis J, Ramsay M, Sircombe N, Skidmore J, Aboushelbaya R, Mayr MW, Paddock R, Wang RHW, Norreys PA. Whole-beam self-focusing in fusion-relevant plasma. Philos Trans A Math Phys Eng Sci 2021; 379:20200159. [PMID: 33280566 PMCID: PMC7741010 DOI: 10.1098/rsta.2020.0159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 06/12/2023]
Abstract
Fast ignition inertial confinement fusion requires the production of a low-density channel in plasma with density scale-lengths of several hundred microns. The channel assists in the propagation of an ultra-intense laser pulse used to generate fast electrons which form a hot spot on the side of pre-compressed fusion fuel. We present a systematic characterization of an expanding laser-produced plasma using optical interferometry, benchmarked against three-dimensional hydrodynamic simulations. Magnetic fields associated with channel formation are probed using proton radiography, and compared to magnetic field structures generated in full-scale particle-in-cell simulations. We present observations of long-lived, straight channels produced by the Habara-Kodama-Tanaka whole-beam self-focusing mechanism, overcoming a critical barrier on the path to realizing fast ignition. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 2)'.
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Affiliation(s)
- B. T. Spiers
- Department of Physics, University of Oxford, Oxford, UK
| | - M. P. Hill
- Atomic Weapons Establishment, Aldermaston, UK
| | - C. Brown
- Atomic Weapons Establishment, Aldermaston, UK
| | - L. Ceurvorst
- CELIA, Université de Bordeaux-CNRS-CEA, Talence, France
| | - N. Ratan
- Department of Physics, University of Oxford, Oxford, UK
| | - A. F. Savin
- Department of Physics, University of Oxford, Oxford, UK
| | - P. Allan
- Atomic Weapons Establishment, Aldermaston, UK
| | - E. Floyd
- Atomic Weapons Establishment, Aldermaston, UK
| | - J. Fyrth
- Atomic Weapons Establishment, Aldermaston, UK
| | - L. Hobbs
- Atomic Weapons Establishment, Aldermaston, UK
| | - S. James
- Atomic Weapons Establishment, Aldermaston, UK
| | - J. Luis
- Atomic Weapons Establishment, Aldermaston, UK
| | - M. Ramsay
- Atomic Weapons Establishment, Aldermaston, UK
| | - N. Sircombe
- Atomic Weapons Establishment, Aldermaston, UK
| | - J. Skidmore
- Atomic Weapons Establishment, Aldermaston, UK
| | | | - M. W. Mayr
- Department of Physics, University of Oxford, Oxford, UK
| | - R. Paddock
- Department of Physics, University of Oxford, Oxford, UK
| | - R. H. W. Wang
- Department of Physics, University of Oxford, Oxford, UK
| | - P. A. Norreys
- Department of Physics, University of Oxford, Oxford, UK
- UKRI-STFC Central Laser Facility, Didcot, UK
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Ireland G, Simmons R, Hickman M, Ramsay M, Sabin C, Mandal S. Monitoring liver transplant rates in persons diagnosed with hepatitis C: a data linkage study, England 2008 to 2017. ACTA ACUST UNITED AC 2020; 24. [PMID: 31615597 PMCID: PMC6794990 DOI: 10.2807/1560-7917.es.2019.24.41.1900176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction Liver transplantation is an important measure of burden from hepatitis C virus (HCV)-associated liver disease. Aims To describe transplant rates and survival in individuals with HCV infection from 2008 to 2017 in England through data linkage. Methods This is a retrospective observational cohort study. Laboratory reports of HCV infection were linked to the Liver Transplant Registry for individuals aged 15 years and over, first diagnosed between 1998 and 2017. We estimated age-sex standardised incidence rates and used Poisson regression to investigate predictors of liver transplantation and test for a change in incidence after introduction of direct-acting antivirals (DAAs) in 2014. Kaplan-Meier survival analysis was used to calculate post-transplant survival rates. Results Of 124,238 individuals diagnosed with HCV infection, 1,480 were registered and 1,217 received a liver transplant. Of individuals registered, 1,395 had post-HCV cirrhosis and 636 had hepatocellular carcinoma (618 also had post-HCV cirrhosis). Median time from HCV diagnosis to transplant was 3.4 years (interquartile range: 1.3–6.8 years). Liver transplant rates were lower 2014–17 compared with 2011–13 (incidence rate ratio: 0.64; 95% confidence interval: 0.55–0.76). Survival rates were 93.4%, 79.9% and 67.9% at 1, 5 and 10 years, respectively. Data linkage showed minimal under-reporting of HCV in the transplant registry. Conclusion In the post-DAA era, liver transplant rates have fallen in individuals with HCV infection, showing early impact of HCV treatment scale-up; but the short time from HCV diagnosis to liver transplant suggests late diagnosis is a problem.
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Affiliation(s)
- G Ireland
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, United Kingdom.,National Infection Service, Public Health England, London, United Kingdom
| | - R Simmons
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, United Kingdom.,National Infection Service, Public Health England, London, United Kingdom
| | - M Hickman
- Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at University of Bristol, Bristol, United Kingdom
| | - M Ramsay
- National Infection Service, Public Health England, London, United Kingdom
| | - C Sabin
- University College London, London, United Kingdom.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, United Kingdom
| | - S Mandal
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, United Kingdom.,National Infection Service, Public Health England, London, United Kingdom
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8
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Tiley K, Tessier E, White JM, Andrews N, Saliba V, Ramsay M, Edelstein M. School-based vaccination programmes: An evaluation of school immunisation delivery models in England in 2015/16. Vaccine 2020; 38:3149-3156. [PMID: 31980192 DOI: 10.1016/j.vaccine.2020.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/28/2022]
Abstract
Schools are increasingly being used to deliver vaccines. In 2015/16 three school-based vaccination programmes were delivered to adolescents in England: human papillomavirus (HPV), meningococcal groups A, C, W and Y disease (MenACWY) and tetanus, diphtheria and polio (Td/IPV). We assessed how school delivery models impact vaccine coverage and how a delivery model for one programme may impact another. Routinely collected national data were analysed to ascertain the school grade achieving highest coverage within each one-dose programme and to compare two-dose delivery models (within year vs across years) for the HPV vaccine. We also assessed whether the HPV delivery model was associated with coverage in other programmes. MenACWY and Td/IPV coverage was highest in younger school grades. Overall similar HPV coverage was achieved with both models (86.7% two doses within one year, 85.8% two doses across two years, p = 0.20). High two-dose HPV coverage in 2015/16 was reported in areas that achieved high HPV coverage in 2013/14 when three doses were required. Areas with high three-dose coverage in 2013/14 achieved higher coverage with a within-one-year approach (92.0% vs 85.2%, p < 0.001), whilst areas reporting low coverage in 2013/14 achieved lower but similar coverage in 2015/16 with both models (79.2% vs 80.9% p = 0.29). MenACWY and Td/IPV coverage were higher in areas with high HPV coverage in 2013/14. Among high HPV coverage areas, MenACWY coverage was higher when HPV doses were delivered within year. School-based programmes should be offered as early as feasible and acceptable to optimise coverage. The choice of delivery model for HPV should take into account local performance and provider experience. Single providers may delivery multiple vaccines and the delivery for one programme may affect the performance of other programmes. Providers should consider local circumstances including past and current vaccine coverage and factors influencing coverage when deciding what delivery model to adopt.
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Affiliation(s)
- K Tiley
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - E Tessier
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
| | - J M White
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - N Andrews
- Statistics, Modelling and Economics Department, National Infection Service, Public Health England, UK
| | - V Saliba
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - M Ramsay
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - M Edelstein
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
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Ireland G, Simmons R, Hickman M, Eastwood B, Ramsay M, Mandal S. Mapping the hepatitis C cascade of care in people attending drug treatment services in England: A data linkage study. Int J Drug Policy 2019; 72:55-60. [PMID: 31257040 DOI: 10.1016/j.drugpo.2019.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Hepatitis C (HCV) infection in England primarily affects people who inject drugs (PWID). We describe persons HCV tested, estimate incidence and establish the cascade of care (CoC) for people engaging with drug services. METHODS Persons testing for HCV in drug services in Sentinel Surveillance of Blood Borne Virus Testing (SSBBV) between 2008 and 2016 were linked with people attending drug services in the National Drug and Treatment Monitoring System (NDTMS). We describe risk characteristics, establish the CoC, and estimate HCV incidence in PWID diagnosed in drug services. RESULTS Of 46,721 persons tested for anti-HCV in SSBBV in drug services, 29,773 (63.7%) linked to NDTMS. Of these, 9100 (30.6%) were antiV positive and anti-HCV positivity was 45.0% in persons reporting urgent housing problems and 43.8% in persons reporting ever injecting. Among persons anti-HCV positive, half had ≥1 positive anti-HCV test. For persons' first anti-HCV positive between 2008 and 2013 (n = 3123), 74.9% were HCV RNA tested, of whom 71.2% were RNA positive, and of these, 14.0% had evidence of interferon-based treatment, with 52.8% achieving cure. Among PWID, HCV incidence was 8.7 per 100 person-years (95% CI: 8.1-9.2). CONCLUSION Through record linkage of surveillance datasets, we estimated the HCV CoC for people attending drug services, providing a benchmark from which to monitor the impact of strategies to scale-up prevention, testing, and curative treatment with direct acting antivirals. Our study highlights wasteful repeated testing and poor linkage to care for this high risk population which need to be addressed.
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Affiliation(s)
- G Ireland
- National Infection Service, Public Health England, UK; The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, UK.
| | - R Simmons
- National Infection Service, Public Health England, UK; The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, UK
| | - M Hickman
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at University of Bristol, UK; Population Health Sciences, Bristol Medical School, UK
| | - B Eastwood
- Alcohol, Drugs, Tobacco and Justice Division, Health Improvement Directorate, Public Health England, UK
| | - M Ramsay
- National Infection Service, Public Health England, UK
| | - S Mandal
- National Infection Service, Public Health England, UK; The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, UK
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10
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Ireland G, Simmons R, Balogun K, Kirwan P, Sabin CA, Ramsay M, Delpech V, Mandal S. HIV coinfection among persons diagnosed with hepatitis B in England in 2008-2014. HIV Med 2019; 20:255-263. [PMID: 30693643 DOI: 10.1111/hiv.12707] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study was to estimate HIV prevalence among persons with hepatitis B virus (HBV) infection in England and to examine associated risk factors. METHODS Persons aged ≥ 15 years with an HBV surface antigen (HBsAg) test reported to Public Health England (PHE) sentinel surveillance during 2008-2014 were linked to the PHE national HIV/AIDS database. Coinfection was defined as an HIV diagnosis prior to, or within 6 months following, a positive HBsAg test. RESULTS During 2008-2014, 2 149 933 persons were tested for HBsAg and 3.9% (1129 of 28 789) of HBsAg-positive persons were HIV positive. The probable route of HIV infection was heterosexual exposure for 95.3% of female patients and 32.3% of male patients, with 61.5% of male patients reporting sex between men. Among African-born coinfected persons, 84% probably acquired HIV there. Predictors of HIV positivity included older age [adjusted odds ratio (aOR) 1.1] and being of black ethnicity (aOR 15.5 for males; aOR 16.4 for females) or being male and of white ethnicity (aOR 8.2) compared with being female and of white ethnicity. HIV coinfection was more likely when HBV was diagnosed in sexual health (aOR 55.0), specialist liver (aOR 6.7), emergency department (aOR 5.3) and renal services (aOR 2.8) compared with general practice. Most (60.4%; 682 of 1129) coinfected persons were diagnosed with HIV infection > 6 months before HBV diagnosis. CONCLUSIONS Persons testing positive for HBsAg had a low HIV infection rate and fell largely into two groups: those of black ethnicity with probable Africa-acquired infections and white men who have sex with men (MSM) with probable UK-acquired infections. Findings reinforce existing recommendations to sustain and improve both HBV testing of migrants from HBV-prevalent countries and vaccination among HIV-positive MSM. Findings also support blood-borne virus testing in sexual health services and emergency departments.
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Affiliation(s)
- G Ireland
- National Infection Service, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - R Simmons
- National Infection Service, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - K Balogun
- National Infection Service, Public Health England, London, UK
| | - P Kirwan
- National Infection Service, Public Health England, London, UK
| | - C A Sabin
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK.,Institute for Global Health, University College London, London, UK
| | - M Ramsay
- National Infection Service, Public Health England, London, UK
| | - V Delpech
- National Infection Service, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - S Mandal
- National Infection Service, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
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11
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Simmons R, Ireland G, Irving W, Hickman M, Sabin C, Ijaz S, Ramsay M, Lattimore S, Mandal S. Establishing the cascade of care for hepatitis C in England-benchmarking to monitor impact of direct acting antivirals. J Viral Hepat 2018; 25:482-490. [PMID: 29239130 DOI: 10.1111/jvh.12844] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/31/2017] [Indexed: 01/01/2023]
Abstract
Little is known about engagement and retention in care of people diagnosed with chronic hepatitis C (HCV) in England. Establishing a cascade of care informs targeted interventions for improving case finding, referral, treatment uptake and retention in care. Using data from the sentinel surveillance of blood-borne virus (SSBBV) testing between 2005 and 2014, we investigate the continuum of care of those tested for HCV in England. Persons ≥1 year old with an anti-HCV test and subsequent RNA tests between 2005 and 2014 reported to SSBBV were collated. We describe the cascade of care, as the patient pathway from a diagnostic test, referral into care, treatment and patient outcomes. Between 2005 and 2014, 2 390 507 samples were tested for anti-HCV, corresponding to 1 766 515 persons. A total of 53 038 persons (35 190 men and 17 165 women) with anti-HCV positive were newly reported to SSBBV. An RNA test was conducted on 77.0% persons who were anti-HCV positive, 72.3% of whom were viraemic (RNA positive) during this time period, 21.4% had evidence of treatment and 3130 49.5% had evidence of a sustained virological response (SVR). In multivariable models, confirmation of viraemia by RNA test varied by age and region/test setting; evidence of treatment varied by age, year of test and region/test setting; and SVR varied by age, year of test and region/setting of test. In conclusion, our findings provide HCV cascade of care estimates prior to the introduction of direct acting antivirals. These findings provide important baseline cascade estimates to benchmark progress towards elimination of HCV as a major public health threat.
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Affiliation(s)
- R Simmons
- Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - G Ireland
- Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - W Irving
- Gastrointestinal and Liver Disorders Theme, NIHR Nottingham Biomedical Research Centre at the Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - M Hickman
- School of Social and Community Medicine, NIHR HPRU in Evaluation, University of Bristol, Bristol, UK
| | - C Sabin
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK.,Infection & Population Health, Institute for Global Health, University College London, London, UK
| | - S Ijaz
- The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - M Ramsay
- Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London, UK
| | - S Lattimore
- Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - S Mandal
- Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London, UK.,The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
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12
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Amirthalingam G, Letley L, Campbell H, Green D, Yarwood J, Ramsay M. Lessons learnt from the implementation of maternal immunization programs in England. Hum Vaccin Immunother 2016; 12:2934-2939. [PMID: 27454010 PMCID: PMC5137530 DOI: 10.1080/21645515.2016.1210730] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/01/2016] [Indexed: 01/11/2023] Open
Affiliation(s)
- G. Amirthalingam
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
| | - L. Letley
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
| | - H. Campbell
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
| | - D. Green
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
| | - J. Yarwood
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
| | - M. Ramsay
- Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, UK
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13
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Yung CF, Ramsay M. Estimating true hospital morbidity of complications associated with mumps outbreak, England, 2004/05. Euro Surveill 2016; 21:30320. [PMID: 27562958 PMCID: PMC4998425 DOI: 10.2807/1560-7917.es.2016.21.33.30320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 06/03/2016] [Indexed: 11/20/2022] Open
Abstract
Mumps outbreaks in highly vaccinated populations continue to be reported globally. Therefore, quantifying the burden of mumps morbidity accurately will be necessary to better assess the impact of mumps vaccination programmes. We aim to estimate the true morbidity resulting from mumps complications in terms of hospitalised orchitis, meningitis, oophoritis and pancreatitis in England during the outbreak in 2004/05. This outbreak in England led to a clear increase in hospitalisations coded to mumps for complications of orchitis in those born in the 1970s and 1980s and possibly for meningitis in those born in the 1980s. A simple statistical model, based on analysing time trends for diagnosed complications in hospital databases with routine laboratory surveillance data, found that the actual morbidity was much higher. There were 2.5 times (166 cases) more mumps orchitis cases in the 1970s cohort and 2.0 times (708 cases) more mumps orchitis cases in the 1980s cohort than complications coded to mumps in hospital databases. Our study demonstrated that the mumps outbreak in England 2004/05 resulted in a substantial increase in hospitalised mumps complications, and the model we used can improve the ascertainment of morbidity from a mumps outbreak.
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Affiliation(s)
- CF Yung
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom
- Infectious Disease Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore
| | - M Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom
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14
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Mandal S, Suh E, Thompson A, Connolly B, Ramsay M, Harding R, Puthucheary Z, Moxham J, Hart N. Comparative study of linear and curvilinear ultrasound probes to assess quadriceps rectus femoris muscle mass in healthy subjects and in patients with chronic respiratory disease. BMJ Open Respir Res 2016; 3:e000103. [PMID: 26835132 PMCID: PMC4716191 DOI: 10.1136/bmjresp-2015-000103] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Ultrasound measurements of rectus femoris cross-sectional area (RFCSA) are clinically useful measurements in chronic obstructive pulmonary disease (COPD) and critically ill patients. Technical considerations as to the type of probe used, which affects image resolution, have limited widespread clinical application. We hypothesised that measurement of RFCSA would be similar with linear and curvilinear probes. Methods Four studies were performed to compare the use of the curvilinear probe in measuring RFCSA. Study 1 investigated agreement of RFCSA measurements using linear and curvilinear probes in healthy subjects, and in patients with chronic respiratory disease. Study 2 investigated the intra-rater and inter-rater agreement using the curvilinear probe. Study 3 investigated the agreement of RFCSA measured from whole and spliced images using the linear probe. Study 4 investigated the applicability of ultrasound in measuring RFCSA during the acute and recovery phases of an exacerbation of COPD. Results Study 1 showed demonstrated no difference in the measurement of RFCSA using the curvilinear and linear probes (308±104 mm2 vs 320±117 mm2, p=0.80; intraclass correlation coefficient (ICC)>0.97). Study 2 demonstrated high intra-rater and inter-rater reliability of RFCSA measurement with ICC>0.95 for both. Study 3 showed that the spliced image from the linear probe was similar to the whole image RFCSA (308±103.5 vs 263±147 mm2, p=0.34; ICC>0.98). Study 4 confirmed the clinical acceptability of using the curvilinear probe during an exacerbation of COPD. There were relationships observed between admission RFCSA and body mass index (r=+0.65, p=0.018), and between RFCSA at admission and physical activity levels at 4 weeks post-hospital discharge (r=+0.75, p=0.006). Conclusions These studies have demonstrated that clinicians can employ whole and spliced images from the linear probe or use images from the curvilinear probe, to measure RFCSA. This will extend the clinical applicability of ultrasound in the measurement of muscle mass in all patient groups.
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Affiliation(s)
- S Mandal
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - E Suh
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - A Thompson
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - B Connolly
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Asthma, Allergy and Lung Biology, King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust and King's College London, National Institute of Health Research Comprehensive Biomedical Research Centre, London, UK
| | - M Ramsay
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
| | - R Harding
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust , London , UK
| | - Z Puthucheary
- Division of Respiratory and Critical Care Medicine , University Medicine Cluster, National University Health Systems , Singapore
| | - J Moxham
- Guy's and St Thomas' NHS Foundation Trust and King's College London, National Institute of Health Research Comprehensive Biomedical Research Centre , London , UK
| | - N Hart
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Asthma, Allergy and Lung Biology, King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust and King's College London, National Institute of Health Research Comprehensive Biomedical Research Centre, London, UK
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15
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Mandal S, Suh ES, Harding R, Vaughan-France A, Ramsay M, Connolly B, Bear D, McLaughlin H, Greenwood S, Polkey M, Elliott M, Douiri A, Moxham J, Hart N. S30 Nutrition and Exercise Rehabilitation in Obesity Hypoventilation Syndrome (NERO): A Pilot Randomised Controlled Trial. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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May S, Mendal S, Ngui SL, Ramsay M, Tedder R, Samreen I. Understanding immunisation failure of neonatal HBV prevention. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Thompson CI, Ellis J, Galiano M, Ramsay M, Brown KE, Zambon M. Detection of influenza A(H3N2) virus in children with suspected mumps during winter 2014/15 in England. ACTA ACUST UNITED AC 2015; 20. [PMID: 26290428 DOI: 10.2807/1560-7917.es2015.20.31.21203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Influenza A(H3N2) virus was detected in oral fluid from 16/107 children (aged 2 to 12 years) with a clinical diagnosis of mumps, who were sampled between December 2014 and February 2015 in England, during the peak of the 2014/15 influenza season. Sequence analysis of an A(H3N2) virus from a child with suspected mumps showed the virus was similar to other circulating A(H3N2) viruses detected in winter 2014/15, which were antigenically drifted from the A(H3N2) vaccine strain.
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Affiliation(s)
- C I Thompson
- Public Health England, Virus Reference Department, Colindale, London, United Kingdom
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18
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Campbell H, Saliba V, Borrow R, Ramsay M, Ladhani SN. Targeted vaccination of teenagers following continued rapid endemic expansion of a single meningococcal group W clone (sequence type 11 clonal complex), United Kingdom 2015. ACTA ACUST UNITED AC 2015. [PMID: 26212140 DOI: 10.2807/1560-7917.es2015.20.28.21188] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since the epidemiological year 2009/10, the United Kingdom has experienced a year-on-year increase in meningococcal group W (MenW) disease due to rapid expansion of a single endemic hyper-virulent strain belonging to sequence type 11 clonal complex (cc). This strain was identified among cases diagnosed across all regions and was not linked to travel abroad. Consequently, an adolescent MenACWY conjugate vaccination programme for 13-18 year-olds will be introduced in August 2015, with priority given to 17-18 year-olds (school leavers).
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Affiliation(s)
- H Campbell
- Public Health England, Immunisation Department, London, United Kingdom
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19
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Frost J, Tikly M, Ramsay M, Estivill X, Rabionet K. THU0012 Observing Dysregulation of Signal Transduction Genes in the WNT Pathway Using two Methods: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Abstract
While many long-term complications of esophageal atresia (EA) have been well investigated, little is known about feeding difficulties in children after surgical correction of EA and its impact on caregivers. This study investigates the feeding behaviors of children with EA through a validated feeding questionnaire. The Montreal Children's Hospital Feeding Scale (MCH-FS) was filled out by the primary caregiver during patient follow-up visits in the multidisciplinary EA clinic. Demographic information, EA subtype, associated anomalies and outcomes were recorded. Results were compared between groups and to a normative sample. Thirty caregivers have completed the MCH-FS; 26 patients had type C atresia (86.7%). In comparison to controls, 17.5% of EA cases are one standard deviation above the mean feeding difficulty score, while 6.7% (n = 2) cases are greater than two standard deviations above normative values. Typical EA patients (type C who were not born <30 weeks) had mean MCH-FS scores in the subclinical range, whereas one extremely premature child and the patients with non-type C EA (n = 4) all had scores in the severe range. Feeding difficulties of patients with typical EA appear mild. Likely explanations include the use of early protocolized care and intensive multidisciplinary care in follow up. Nonetheless, patients with complicated EA (non-type C) and their caregivers tend to experience significant feeding difficulties. Early targeted care may be required for this patient subset, and additional cases will be investigated to confirm these preliminary findings and explore further risk factors of feeding problem in this cohort.
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Affiliation(s)
- R Baird
- Department of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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21
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Martin NK, Foster GR, Vilar J, Ryder S, E Cramp M, Gordon F, Dillon JF, Craine N, Busse H, Clements A, Hutchinson SJ, Ustianowski A, Ramsay M, Goldberg DJ, Irving W, Hope V, De Angelis D, Lyons M, Vickerman P, Hickman M. HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact. J Viral Hepat 2015; 22:399-408. [PMID: 25288193 PMCID: PMC4409099 DOI: 10.1111/jvh.12338] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37-48% HCV chronic prevalence among PWID), East London (37-48%), Manchester (48-56%), Nottingham (37-44%), Plymouth (30-37%), Dundee (20-27%) and North Wales (27-33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33-57%] and 61% genotypes 2/3 [95%CI 47-76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence.
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Affiliation(s)
- N K Martin
- School of Social & Community Medicine, University of BristolBristol, UK,Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical MedicineLondon, UK,
Correspondence: Natasha K. Martin, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. E-mail:
| | - G R Foster
- Blizard Institute, Queen Mary's University of LondonLondon, UK
| | - J Vilar
- Pennine Acute Hospitals NHS TrustGreater Manchester, UK
| | - S Ryder
- Nottingham University Hospitals NHS TrustNottingham, UK
| | - M E Cramp
- Plymouth Hospital NHS TrustPlymouth, UK
| | - F Gordon
- University of Bristol Health TrustBristol, UK
| | | | - N Craine
- Health Protection WalesBangor, Wales, UK
| | - H Busse
- School of Social & Community Medicine, University of BristolBristol, UK
| | | | - S J Hutchinson
- Glasgow Caledonian UniversityGlasgow, UK,Health Protection ScotlandGlasgow, UK
| | - A Ustianowski
- Pennine Acute Hospitals NHS TrustGreater Manchester, UK
| | | | | | - W Irving
- University of NottinghamNottingham, UK
| | - V Hope
- Public Health EnglandLondon, UK
| | | | - M Lyons
- Health Protection WalesBangor, Wales, UK
| | - P Vickerman
- School of Social & Community Medicine, University of BristolBristol, UK,Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical MedicineLondon, UK
| | - M Hickman
- School of Social & Community Medicine, University of BristolBristol, UK
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22
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Affiliation(s)
- S Mandal
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - M Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - K Brown
- Virus Reference Department, Public Health England, London, United Kingdom
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23
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Guy R, Williams C, Irvine N, Reynolds A, Coelho J, Saliba V, Thomas D, Doherty L, Chalker V, von Wissmann B, Chand M, Efstratiou A, Ramsay M, Lamagni T. Increase in scarlet fever notifications in the United Kingdom, 2013/2014. ACTA ACUST UNITED AC 2014; 19:20749. [PMID: 24698137 DOI: 10.2807/1560-7917.es2014.19.12.20749] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Increases in scarlet fever above usual seasonal levels are currently being seen across the United Kingdom. Medical practitioners have been alerted to the exceptional increase in incidence. Given the potential for this to signal a population increase in invasive group A streptococcal disease, close monitoring of invasive disease is essential.
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Affiliation(s)
- R Guy
- Public Health England, London, United Kingdom
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24
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Mandal S, Suh E, Kamalanathan M, Ramsay M, Harding R, Moxham J, Hart N. P178 Nocturnal oximetry monitoring to predict hypercapnia in obese patients. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Drake S, Ramsay M, Steier J, Hart N. S86 Change in patient demographics and Home Mechanical Ventilation (HMV) set up for patients with chronic respiratory failure between 2006 and 2012: Abstract S86 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Collins S, Ramsay M, Campbell H, Slack MPE, Ladhani SN. Invasive Haemophilus influenzae Type b Disease in England and Wales: Who Is at Risk After 2 Decades of Routine Childhood Vaccination? Clin Infect Dis 2013; 57:1715-21. [DOI: 10.1093/cid/cit579] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Govind N, Reynolds RJ, Hodkinson B, Ickinger C, Frost J, Ramsay M, Causey Z, Bridges SL, Tikly M. OP0053 HLA DRB1 Amino Acid Position 11 is Strongly Associated with Seropositive Rheumatoid Arthritis in Black South Africans. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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28
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Abstract
Esophageal atresia (EA) is one of the congenital neonatal anomalies whose immediate consequence for the newborn is the inability to feed. Most centers strive to minimize the effects of surgeries and subsequent postoperative complications such as esophageal strictures, respiratory problems, and gastrointestinal reflux on the child's ability or motivation to feed. Feeding difficulties in early infancy may not only interrupt maternal expectations of becoming providers of nutrition to their infants but may also influence the infant's development of sensory motor skills and parent-child relationships. Early involvement by a multidisciplinary team consisting of occupational therapist, nutritionist, and psychologist is an important addition to the surgical and medical team. The team assists in preparing mothers for feeding-related difficulties, providing anticipatory guidance to improve feeding abilities and relationships, especially for children with multiple surgical involvements and prolonged periods of non-oral feeding.
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Affiliation(s)
- M Ramsay
- Department of Psychology, Montreal Children's Hospital, McGill University Health Centre, Montreal QC H3H 1P3, Quebec, Canada.
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29
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Mandal S, Suh E, Connolly B, Ramsay M, Puthucheary Z, Moxham J, Hart N. P40 Change in Rectus Femoris Cross Sectional Area (RFcsa) Following an Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD): Abstract P40 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, Ladhani S, Watson C, Ramsay M, Kaczmarksi E, Borrow R, Gray S, Hadlington D, Weinbren M, Bhattacharjee D, Inglis N. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.44.20308-en] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report an outbreak of Neisseria meningitidis serogroup W135, associated with a transient transmission event between asymptomatic individuals in a healthcare setting. Two elderly persons subsequently developed invasive meningococcal disease. The duration and type of close contact for those directly involved in the probable transmission incident would not have warranted chemoprophylaxis according to current guidelines. Meningococcal infection in older persons usually presents with pneumonia rather than meningitis or septicaemia with purpura.
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Affiliation(s)
- R Puleston
- Health Protection Agency, Nottingham, United Kingdom
| | - C Beck
- Health Protection Agency, Nottingham, United Kingdom
| | - M Tahir
- Health Protection Agency, Birmingham, United Kingdom
| | - M Bardhan
- Health Protection Agency, Birmingham, United Kingdom
| | - P Charlemagne
- Health Protection Agency, Birmingham, United Kingdom
| | - C Alves
- Health Protection Agency, Birmingham, United Kingdom
| | - S Ladhani
- Health Protection Agency, London, United Kingdom
| | - C Watson
- Health Protection Agency, London, United Kingdom
| | - M Ramsay
- Health Protection Agency, London, United Kingdom
| | - E Kaczmarksi
- Meningococcal Reference Unit, Health Protection Agency, Public Health Laboratory, Manchester, United Kingdom
| | - R Borrow
- Meningococcal Reference Unit, Health Protection Agency, Public Health Laboratory, Manchester, United Kingdom
| | - S Gray
- Meningococcal Reference Unit, Health Protection Agency, Public Health Laboratory, Manchester, United Kingdom
| | - D Hadlington
- West Midlands Ambulance Service, West Midlands, United Kingdom
| | - M Weinbren
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - D Bhattacharjee
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - N Inglis
- NHS Coventry and Warwickshire, Coventry, United Kingdom
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31
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Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, Ladhani S, Watson C, Ramsay M, Kaczmarksi E, Borrow R, Gray S, Hadlington D, Weinbren M, Bhattacharjee D, Inglis N. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill 2012; 17:20308. [PMID: 23137486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- R Puleston
- Health Protection Agency, Nottingham, United Kingdom.
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32
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Abstract
Child Health Information Systems (CHISs) are computerised clinical record systems which support a range of health promotion and prevention activities for children, including immunisation and screening. There are a number of different providers of CHISs in England. These systems are managed by child health departments in each local area and not all are interoperable. The establishment of systems which record and maintain accurate information on the entire population is critical to assess vaccination coverage at both national and local levels. These systems should have the flexibility to adapt to a continuously evolving immunisation programme, a mechanism to rapidly feedback to local public health teams for outbreak prevention and control, and the ability to mount a timely response to vaccine safety scares. The ability to schedule (call and recall) immunisation appointments has contributed to improvements in vaccination coverage both in England and elsewhere. While this has been achieved in England through multiple CHISs the development of a single national register would reduce the complexities of maintaining accurate and complete immunisation records for the entire population.
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Affiliation(s)
- G Amirthalingam
- Immunisation, Hepatitis and Blood Safety Department, Health Protection Services, Health Protection Agency, London, United Kingdom
| | - J White
- Immunisation, Hepatitis and Blood Safety Department, Health Protection Services, Health Protection Agency, London, United Kingdom
| | - M Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Health Protection Services, Health Protection Agency, London, United Kingdom
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33
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Amirthalingam G, White J, Ramsay M. Measuring childhood vaccine coverage in England: the role of Child Health Information Systems. Euro Surveill 2012; 17:20149. [PMID: 22551461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Child Health Information Systems (CHISs) are computerised clinical record systems which support a range of health promotion and prevention activities for children, including immunisation and screening. There are a number of different providers of CHISs in England. These systems are managed by child health departments in each local area and not all are interoperable. The establishment of systems which record and maintain accurate information on the entire population is critical to assess vaccination coverage at both national and local levels. These systems should have the flexibility to adapt to a continuously evolving immunisation programme, a mechanism to rapidly feedback to local public health teams for outbreak prevention and control, and the ability to mount a timely response to vaccine safety scares. The ability to schedule (call and recall) immunisation appointments has contributed to improvements in vaccination coverage both in England and elsewhere. While this has been achieved in England through multiple CHISs the development of a single national register would reduce the complexities of maintaining accurate and complete immunisation records for the entire population.
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Affiliation(s)
- G Amirthalingam
- Immunisation, Hepatitis and Blood Safety Department, Health Protection Services, Health Protection Agency, London, United Kingdom.
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34
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Abstract
A cluster of four confirmed cases of meningococcal disease was seen in the same nuclear family across a 15-week period. The cases were three siblings and a parent and all recovered well. The first case was confirmed by meningococcal PCR only but the subsequent three cases were due to indistinguishable strains of serogroup B (B:NT:P1.19-1,15-11). Contact tracing was initially undertaken and reviewed in detail after each subsequent case. Antibiotic prophylaxis was administered to close family contacts on three separate occasions, including switching of antibiotic agents, with good compliance. Subsequent investigation of the family has not revealed any obvious immunological problem and no further significant infections have been recognised. A cluster of meningococcal disease of this nature and timescale is highly unusual. Details of the cluster, investigation and implications for health protection practice are discussed.
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Affiliation(s)
- P Acheson
- Health Protection Agency North East, North East Health Protection Unit, Floor 2, Citygate, Gallowgate, Newcastle upon Tyne NE1 4WH, UK.
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35
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Carvalho C, Thomas HL, Balogun K, Tedder R, Pebody R, Ramsay M, Ngui SL. A possible outbreak of hepatitis A associated with semi-dried tomatoes, England, July–November 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.06.20083-en] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In October 2011, two primary cases of hepatitis A virus (HAV) infection with identical HAV genotype IB strains to those seen in other outbreaks associated with semi-dried tomatoes were reported in England. Both cases had consumed semi-dried tomatoes. Epidemiological investigations revealed two additional cases of genotype IB strains with different sequences who also reported having consumed semi-dried tomatoes. In November, five cases of HAV infection with closely related strains were identified in the Netherlands. A foodborne multiple-strain outbreak is suspected.
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Affiliation(s)
- C Carvalho
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - H L Thomas
- Field Epidemiology Training Programme (FETP), Health Protection Agency, United Kingdom
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - K Balogun
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - R Tedder
- Health Protection Agency, Microbiology Services Colindale, London, United Kingdom
| | - R Pebody
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - M Ramsay
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
| | - S L Ngui
- Health Protection Agency, Microbiology Services Colindale, London, United Kingdom
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36
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Carvalho C, Thomas H, Balogun K, Tedder R, Pebody R, Ramsay M, Ngui S. A possible outbreak of hepatitis A associated with semi-dried tomatoes, England, July-November 2011. Euro Surveill 2012; 17:20083. [PMID: 22340975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
In October 2011, two primary cases of hepatitis A virus (HAV) infection with identical HAV genotype IB strains to those seen in other outbreaks associated with semi-dried tomatoes were reported in England. Both cases had consumed semi-dried tomatoes. Epidemiological investigations revealed two additional cases of genotype IB strains with different sequences who also reported having consumed semi-dried tomatoes. In November, five cases of HAV infection with closely related strains were identified in the Netherlands. A foodborne multiple-strain outbreak is suspected.
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Affiliation(s)
- C Carvalho
- Health Protection Agency, Health Protection Services Colindale, London, United Kingdom
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37
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Frost J, Ramsay M, Mia R, Moosa L, Musenge E, Tikly M. Differential gene expression of MMP-1, TIMP-1 and HGF in clinically involved and uninvolved skin in South Africans with SSc. Rheumatology (Oxford) 2012; 51:1049-52. [DOI: 10.1093/rheumatology/ker367] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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38
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Suh E, Ramsay M, Mandal S, Boleat E, Christian B, Henderson K, Murphy P, Moxham J, Hart N. S116 Parasternal muscle electromyelography (EMGpara) reflects observed changes in dynamic hyperinflation during acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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39
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Abstract
Despite the introduction of blood donor screening, worldwide, children continue to become infected with hepatitis C virus (HCV) via un-sterile medical injections, receipt of unscreened blood and isolated hospital contamination outbreaks. It is plausible that the natural history and disease progression in these children might differ from that of their vertically infected counterparts. Vertically and parenterally HCV-infected children were prospectively followed within the European Paediatric HCV Network and the UK National HCV Register, respectively. Biological profiles were compared. Vertically and parenterally HCV-infected children differed in terms of some key characteristics including the male to female ratio and the proportion of children receiving therapy. Parenterally infected children were more likely to have at least one hepatomegaly event during follow-up, 20%vs 10%. Parenteral infection did not significantly affect the odds of being consistently viraemic (AOR 1.14, P = 0.703) and there was no significant difference in the odds of having consistently elevated ALT levels and mode of acquisition (AOR 0.83, P = 0.748). The proportion of children with 2 or more markers of HCV infection did not differ significantly by mode of acquisition (χ(2) 1.13, P = 0.288). This analysis does not support substantial differences between vertically and parenterally infected groups, but there are specific mechanisms identified requiring further investigation. Given the continued parenteral infection of children worldwide, it is vital that knowledge of disease progression in this group is accurate and that the differences in comparison with vertically infected children are clarified to inform more accurate and individualized clinical management.
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Affiliation(s)
- K England
- MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK.
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40
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Zakikhany K, Degail MA, Lamagni T, Waight P, Guy R, Zhao H, Efstratiou A, Pebody R, George R, Ramsay M. Increase in invasive Streptococcus pyogenes and Streptococcus pneumoniae infections in England, December 2010 to January 2011. Euro Surveill 2011; 16:19785. [PMID: 21315057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Increases in invasive Streptococcus pyogenes and S. pneumoniae above the seasonally expected levels are currently being seen in England. Preliminary analyses suggest that the high level of influenza activity seen this winter may be contributing to an increased risk of concurrent invasive bacterial and influenza infections in children and young adults.
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Affiliation(s)
- K Zakikhany
- Health Protection Agency, London, United Kingdom
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41
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Zakikhany K, Degail MA, Lamagni T, Waight P, Guy R, Zhao H, Efstratiou A, Pebody R, George R, Ramsay M. Increase in invasive Streptococcus pyogenes and Streptococcus pneumoniae infections in England, December 2010 to January 2011. Euro Surveill 2011. [DOI: 10.2807/ese.16.05.19785-en] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Increases in invasive Streptococcus pyogenes and S. pneumoniae above the seasonally expected levels are currently being seen in England. Preliminary analyses suggest that the high level of influenza activity seen this winter may be contributing to an increased risk of concurrent invasive bacterial and influenza infections in children and young adults.
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Affiliation(s)
- K Zakikhany
- The European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Health Protection Agency (HPA), London, United Kingdom
| | - M A Degail
- The European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Health Protection Agency (HPA), London, United Kingdom
| | - T Lamagni
- Health Protection Agency (HPA), London, United Kingdom
| | - P Waight
- Health Protection Agency (HPA), London, United Kingdom
| | - R Guy
- Health Protection Agency (HPA), London, United Kingdom
| | - H Zhao
- Health Protection Agency (HPA), London, United Kingdom
| | - A Efstratiou
- Health Protection Agency (HPA), London, United Kingdom
| | - R Pebody
- Health Protection Agency (HPA), London, United Kingdom
| | - R George
- Health Protection Agency (HPA), London, United Kingdom
| | - M Ramsay
- Health Protection Agency (HPA), London, United Kingdom
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42
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Viswanathan U, Beaumont A, O'Moore E, Ramsay M, Tedder R, Ijaz S, Balogun K, Kirwan P. Hepatitis B transmission event in an English prison and the importance of immunization. J Public Health (Oxf) 2010; 33:193-6. [DOI: 10.1093/pubmed/fdq083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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43
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Uddin G, Shoeb D, Solaiman S, Marley R, Gore C, Ramsay M, Harris R, Ushiro-Lumb I, Moreea S, Alam S, Thomas HC, Khan S, Watt B, Pugh RN, Ramaiah S, Jervis R, Hughes A, Singhal S, Cameron S, Carman WF, Foster GR. Prevalence of chronic viral hepatitis in people of south Asian ethnicity living in England: the prevalence cannot necessarily be predicted from the prevalence in the country of origin. J Viral Hepat 2010; 17:327-35. [PMID: 20002307 DOI: 10.1111/j.1365-2893.2009.01240.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The prevalence of hepatitis B and hepatitis C in immigrant communities is unknown. Immigrants from south Asia are common in England and elsewhere, and the burden of viral hepatitis in these communities is unknown. We aimed to determine the prevalence of viral hepatitis in immigrants from south Asia living in England, and we therefore undertook a community-based testing project in such people at five sites in England. A total of 4998 people attending community centres were screened for viral hepatitis using oral fluid testing. The overall prevalence of anti-hepatitis C virus (HCV) in people of south Asian origin was 1.6% but varied by country of birth being 0.4%, 0.2%, 0.6% and 2.7% in people of this ethnic group born in the UK, India, Bangladesh and Pakistan, respectively. The prevalence of hepatitis B surface antigen was 1.2%-0.2%, 0.1%, 1.5% and 1.8% in people of this ethnic group born in the UK, India, Bangladesh and Pakistan, respectively. Analysis of risk factors for HCV infection shows that people from the Pakistani Punjab and those who have immigrated recently are at increased risk of infection. Our study suggests that migrants from Pakistan are at highest risk of viral hepatitis, with those from India at low risk. As prevalence varies both by country and region of origin and over time, the prevalence in migrant communities living in western countries cannot be easily predicted from studies in the country of origin.
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Affiliation(s)
- G Uddin
- Queen Marys University of London, Barts and The London School of Medicine, The Liver Unit, 4 Newark Street, London, UK
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44
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Tweed E, Hale A, Hurrelle M, Smith R, Delpech V, Ruf M, Klapper P, Ramsay M, Brant L. Monitoring HIV testing in diverse healthcare settings: results from a sentinel surveillance pilot study. Sex Transm Infect 2010; 86:360-4. [DOI: 10.1136/sti.2009.041293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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45
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Manikkavasagan G, Brown K, Ramsay M. Re: Manikkavasagan G, Ramsay M. 2009. The rationale for the use of measles post-exposure prophylaxis in pregnant women: a review. Journal of Obstetrics and Gynaecology 29(7):574-577. J OBSTET GYNAECOL 2010; 30:218. [PMID: 20144000 DOI: 10.3109/01443610903506180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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46
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Abstract
A review of published literature was undertaken to investigate the maternal and fetal effects of measles infection in pregnancy and to inform the need for post-exposure prophylaxis. There is no evidence to support an association between measles in pregnancy and congenital defects. However, the need for effective post-exposure protection is supported by studies suggesting a high risk of severe maternal morbidity, fetal loss and prematurity. Measles in late pregnancy can also lead to perinatal infection in the infant, which may be associated with a high mortality and the risk of subacute sclerosing panencephalitis. UK guidance recommends using human normal immunoglobulin for susceptible pregnant women exposed to measles. Although there is no direct evidence that this will reduce the complications of measles in pregnancy, it may attenuate disease and therefore reduce the rate of complications. Measures to identify women likely to be susceptible include assessment of age, vaccination history, and/or antibody testing.
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47
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Tikly M, Govind N, Frost J, Ramsay M. The PTPN22 R620W polymorphism is not associated with systemic rheumatic diseases in South Africans. Rheumatology (Oxford) 2009; 49:820-1. [DOI: 10.1093/rheumatology/kep399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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48
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Cronjé L, Becker P, Paterson A, Ramsay M. Hereditary non-polyposis colorectal cancer is predicted to contribute towards colorectal cancer in young South African blacks. S AFR J SCI 2009. [DOI: 10.4102/sajs.v105i1/2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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49
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Schinke RJ, Ramsay M. World title boxing: from early beginnings to the first bell. J Sports Sci Med 2009; 8:1-4. [PMID: 24474878 PMCID: PMC3879639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2008] [Accepted: 07/30/2009] [Indexed: 06/03/2023]
Abstract
There is scant literature where applied sport scientists have considered first hand experiences preparing professional boxers for world title bouts. The present submission reflects more than 10 years of applied experience working with professional boxers, residing in Canada. What follows is a composite of sequential steps that ownership and coaching staff of one Canadian management group have tried leading up to more than 20 world title bout experiences. The strategies proposed have been built progressively over time, and what follows is a general overview of a more detailed pre-bout structure from shortly in advance of a world title bout offer to the moment when the athlete enters the ring to perform. We propose that an effective structure is founded upon detailed a priori preparation, tactical decisions throughout bout preparation, and a thorough understanding by the athlete of what he will encounter during the title bout. Key PointsWorld championship boxing.Competition preparation.Professional sport.Athlete performance.
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50
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Tweed E, Brant L, Hurrelle M, Klapper P, Ramsay M. Hepatitis C testing in sexual health services in England, 2002-7: results from sentinel surveillance. Sex Transm Infect 2009; 86:126-30. [DOI: 10.1136/sti.2009.036590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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